This bipartisan legislation will help create a more transparent process that allows patients and physicians to seek exceptions to step therapy protocol. Although it only applies to employer-sponsored health plans, the bill represents an important step towards reining in this troubling practice.
Compared to government payers, commercial payers take significantly longer to pay hospitals and deny claims at a higher frequency — often without a justifiable reason to do so — according to a new report. Commerical payers have better reimbursement rates than government payers, but providers often have to wait 90 days or more get claims paid by commercial plans.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
In this complex and rapidly changing claims denial environment, providers must take a proactive approach to stay ahead of the game. Here's what providers can do to successfully navigate the audit landscape.
UHC has been sued by a Florida attorney for denying coverage of proton beam radiation therapy for prostate cancer patients. The judge in the case, simply by recusing, sends a strong message.